Bergeron

Bergeron v. Department of Health Services

Good Law
1999 Cal. App. LEXIS 300·71 Cal. App. 4th 17·83 Cal. Rptr. 2d 481·99 Daily Journal DAR 3115·99 Cal. Daily Op. Serv. 2407
Court of Appeal of CaliforniaMarch 31, 1999F029448California3,662 words

Opinion

Opinion

Thaxter, J.

—In this appeal from a judgment denying appellant Marie Bergeron’s petition for writ of mandate, we hold that due process does not require respondent California Department of Health Services (Department) to hold an administrative hearing as to its right to withhold payment of fees claimed by appellant, a Medi-Cal provider, for dental services she rendered. The decision to withhold was made pending an investigation into appellant’s billing practices and was authorized by 42 Code of Federal Regulations section 455.23 (1998).

Facts

Appellant is a dentist engaged in the practice of dentistry in Visalia, California under the name Visalia Dental Practice. Her primary clients during the relevant times were indigent patients who are beneficiaries of Medi-Cal services. Under the Medi-Cal system, appellant provides services to patients entitled to receive Medi-Cal benefits and then bills the Department for the services rendered. The Department, using a fiscal intermediary (Delta Dental), reviews the bills in accordance with the regulatory scheme and, upon approval of appellant’s bills, makes payment. The relationship between appellant, as a Medi-Cal service provider, and the…

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